Modernizing Clinic Options for Directed Gamete and Embryo Donation

Explore the evolution of gamete insemination laws, ethics, and rights for donor-conceived individuals from 1884 to present-day privacy shifts.

My name is Amanda Troxler. I'm a fertility attorney. I'd like to talk a little bit about the history of gamete insemination.

The first medically reported medical artificial insemination occurred in 1884. Obviously, we've had artificial insemination since before then. This is the first time it was recorded.

In that case, it was in Philadelphia. A doctor suspected that the infertility was coming from the husband rather than the wife, so he decided to drug the woman with chloroform, and he used the syringe to inject her with sperm from his best-looking medical student. He did not tell her about the procedure.

Eventually, he felt so guilty that he confessed to the husband. Anyway, if we know that this thing would only happen in 1884, and that would never be this sort of secrecy that's harmful to people nowadays, we should also keep in mind that as late as the 1990s, fertility doctors were using their own sperm without telling their patients, and in some instances, fathering up to 94 offspring. Then in 1970s, the sperm bank starts operating, and we see more cryopreserved sperm.

In that case, the doctors told the patients, no one has to know to go home, have sex, never think about again, certainly don't tell the child. The reasons that they told people to do this is stigma associated with male infertility, also concerns about the child and things like legitimacy. Ultimately, the providers don't have to keep track of the donors if they're not keeping any records.

I'd also like to mention in 1974, the ABA approved the Uniform Parentage Act, so that provided that if a wife is inseminated with the donor sperm with their husband's consent, that the husband is the father. In 1983, Australia reported its first non-successful pregnancy from donated eggs, and the United States had its first birth in 1984. Then we start to see in 2004, the Ethics Committee's report stating that we may want to inform your child of their donor conception status.

It supported the trend of open disclosure, but said it's a highly personal decision and one for the parents to make. Then we see 2008, Facebook and the social media era, which just exploded out from college towns to the general population. There's lots of information sharing, people's ideas of privacy start to shift, and then look to now, the amount of information you can find out about someone online is a lot.

In 2009, we start to see direct consumer DNA testing. Many people start to find out that their donor conceived, that they have misattributed paternity, or the parents are not who they expected them to be. In 2011, Washington passed a law that said the donor conceived people have a right to the donor's medical history and full name at 18, although the donor can opt out.

That was a step in the direction of open donations or at least bringing up that conversation. In 2016, we start to see the rise of donor conceived groups providing information community for people who find out that their donor conceived or not parent expected and resources for those people. In 2022, there's a Colorado law and DCP task force that was formed.

It takes effect in January 2025. The main features are that the DCP or donor conceived people, and I say DCP, have the right to the donor's identity at 18. It caps the number of families from one to the donor.

It permanently maintains medical records and regularly has an obligation to update medical information. The minimum age of donors is raised to 21. These are just signals that donor conceived people's voices, which have typically been ignored and historically ignored, are being taken seriously.

I've heard that there's lawmakers in other states would like to see similar laws passed in their own state. And as of 2023, over 100 million people have used direct-to-consumer DNA testing.